the view from up here

So, Obie and I moved waaaay up to northern Maine practically on top of the border with Canada.  Our first morning here it was -15.  He tried to balance on two legs while peeing, and glared at me for all he was worth before scampering back to the front door expecting to escape the chill.  Luckily things have only gotten better since then, and I survived my first week of surgery minus the Monday holiday!  50 hours later I am wondering what a full week will look and feel like, cause pseudo week felt a little like a train running me down.

It takes a surprising amount of muscle to stand in one place for a four hour surgery while holding your arms mid body so as to not break the sterile field, and then intermittently holding a clamp for just long enough to make you develop a fine tremor before releasing it and returning to mid body robot stance.  And at the end of that, it's almost amusing how shaky and jittery you are when you are asked to do the one task your baby student hands are somewhat capable of handling: suturing the incision closed.  Sutures in the ED are one thing. Pull up a chair and stay awhile why don't you!  On my last rotation a nurse came in to the room just as I was finishing up an arm laceration to ask me if I'd like him to bring in the sewing machine because it had been quite a long time since I had started.  Well, in the OR, ain't nobody got time for that!  At the end of a long surgery, it's lickety split time and you better step briskly so you don't get run over.  Which is why when you are finally up to bat, after standing immobilized for forever,  it's the worst time for the muscle memory of movement to momentarily escape you!  Thus, I spent one afternoon practicing on a chair in between patients.

But, I'm getting ahead of myself.  In fact, week one was good.  Exhausting and awkward and funny and good in spite of it all.  And this means I only have one more first week of rotations to go.  One more round of accidentally introducing myself to the same person three or more times, one more awkward hover dance in the doorway of my preceptors office while I try to decide where to situate my body so it's most out of the way, one more building to get lost in the layout of, one more set of codes to memorize to get into the various restricted places.   SO CLOSE.

Yesterday and today I woke up to beautiful sunny days with temperatures above zero!  Julia, Oliver, and I took advantage of the lull in precipitation to go snowshoeing.  It was absolutely gorgeous!

We blazed a trail in the back of our house, which was a ton of work, but really fun.  I tried to get a video of O trying to navigate the snow, but was unsuccessful.  So in words this is what he looks like:  three steps on the surface of the snow because he doesn't weigh too much, and then his back half will sink, causing his front half to sink while he attempts to pull himself out of the hole, then a couple more steps on the surface and sink, sink, sink, surface, surface, surface.  He alternates between that and following in our trail, so closely that he is more often standing on the snow shoe and looks personally affronted when you lift your foot up and startle him.  I know, his life is very hard.  He is currently passed out at my feet from all the excitement.  I think he likes life up north so far!

and then I realized I am that person

Sooooo, in a weird fit of anxiety induced paranoia, I may have convinced myself that Oliver has diabetes.  Yes I wrote that right.  And hindsight being what it is, I think we can now all collectively agree that that is a fairly ridiculous leaping conclusion on my part, but that's probably at least in part because we all now know that it isn't true.

Polyuria + polydipsia + one accident at home = diabetes for sure.  So of course I called up my vet and got an appointment on Friday.  I thoroughly embarrassed myself trying to get a urine sample from him by collecting it into a vitamin water bottle.  It did not go as well as one would hope, but probably as well as one would imagine.  To be fair, he was also behind on a few immunizations, so I figured kill two birds, right?  Maybe that is an inappropriate cliche to use in this context.

Of course when we are in the patient room and I hear the words coming out of my mouth, I instantly snap back to reality and realize that I am a crazy person, and there is no way that my dog has diabetes.  He has no other symptoms, hasn't even had these ones long, is otherwise his completely normal neurotic self, and also he does not have diabetes.  And that's when I realize that in that moment I am totally one of my pediatric patient's parents!  Worried well!  Sometimes I know that when I am seeing a kid with complaints of a runny nose for two days, as his mom is recounting the history she is also in the process of realizing there is no need to be being seen in the doctor's office.  That was me.  I just wanted to stand up and say, ok, take my money, we can go now.  I swear I am usually a fairly competent person, and if this was an actual human child I probably wouldn't have been so insane.  Or who knows, maybe I would have been even crazier, cause hormones can do weird things.

So for now, let's all just take a moment to be glad that Oliver doesn't have diabetes.  And you personally can all be glad that you didn't just pay through the nose to ascertain that.  And now here are some pictures of Obie being adorable while simultaneously maintaining a normal blood sugar:

And one of him small:

That is all.

snow day!

The best part about being back on campus for a week is having a giant snow storm blow through and school gets cancelled!  Out in the world of clinical rotations, work rarely gets cancelled, and since we are all scattered across New England, there is no consistent climate for blanket cancellations.  Makes me sound like I don't like what I do, BUT seriously, who doesn't enjoy a free hunker down day with no responsibilities and fat snowflakes falling briskly outside your window?  I maaay have also given myself even more time off and slept in on Thursday missing a billing/coding lecture...and then spent the  rest of the day reading and lounging and eating delicious sushi with friends.  I tell you, EOR weeks are exhausting, and I needed some serious sleep! 

With no lectures for the day, this week of productivity has officially been closed.  I super survived my OSCE, and breathed a huge sigh of relief afterwards.  Last OSCE forever?  I'll take that.  On exam day I only had to take one because Belize was my elective.  My fellow traveling classmates and I used the first exam time slot to go out for a delicious breakfast to reminisce about warmer, sunnier, climates, and catch up on life since returning home.  It was great!  I missed those girls!  My Emergency Medicine exam went really well.  I think I am FINALLY (after 25 years of schooling) getting the hang of standardized exams.  Sheesh! And not a moment too soon either, cause folks I have only TWO more exams until graduation.  It seems almost unbelievable, but it's true.  Then of course there is my gigantic board exam afterwards, but that's extra, and doesn't apply to this conversation. 

To celebrate the storm JP and I braved the roads and grabbed local seafood at the fish market before heading up the road to Joe's to make dinner.  He's been traveling a lot lately, and I am about to move, so we have been squeezing in sibling hang time when we can.  My mom recently sent him a package with pasta maker, and, among other things, four separate hand mixed packs for GF pasta.  What better time to make homemade pasta?!  I am not sure  we were completely successful, but there was enough for Emma and I, while the boys made due with the packaged, fully gluten-ed variety.  Fresh salad, pasta, shrimp and scallops make for quite the delectable dinner.  We brought chocolate stout and vino verde to bring it all together.  YUM. 

 Doesn't that look scrumptious?!  Don't tell my future surgical patients about my uneven cuts...shhh.

But speaking of surgery, did you know that that is my next rotation?!  I am terrified, and ecstatic, and nervous!  I have such conflicting feelings already.  I think I am going to love it, but secretly kind of hope I hate it because the lifestyle is just so demanding and leaves little room for life outside the hospital.  Also, I know I'm going to look like such a flop at first because I've only been in the OR twice, and it's been forever since my anatomy classes, and I don't know how to tie a knot with one hand!  These are the problems people!  The problems!!

Ok, so anyways I shall stop freaking out.  Surgery rotation starts Tuesday, and it is in Presque Isle, ME which is about five hours north of Portland, practically in Canada.  I've been fortunate to find housing that accepts not only me, but my lovable sweet Oboe boy as well.  Middle of nowhere is much more manageable with the O by my side, PLUS I get to live with Julia who I have barely seen since second year started.  This rotation promises to be full of anxiety, and excitement, and hijinks, and girly wine time, and trail runs.  I should probably go pack, and obsessively watch knot tying youtube videos. 

and I didn't even cry!

This morning there was lots of fresh snow on the ground and on my car.  I left the house with perfect timing, and then lost time clearing off my car, and lost a little more time when the highway speed limit was reduced form 65 to 45 for weather, but I arrived to my exam exactly 2 min early after nearly rear ending a prius.  My patient however was not as lucky, and since her car was in a snow bank, my exam was postponed until further notice.  NO NEED TO PANIC.  Although, after announcing to my professor (and subsequently high fiving him), that I would not be crying today, he did jokingly ask if I was carrying any weapons (to which I of course replied, only mace so if things go awry I can just spray you in the face and make a run for it...these are the moments I wish I had a filter).  Luckily he thought it was hilarious?

BUT my patient did arrive soon after the announcement, and hurried into her room to pretend to be another person with no past history of snowbanks and such.  Unfortunately, there was such a rush to get her settled, no one thought to give her the "findings" cards.  For example, when you listen to the lungs her lungs would sound clear, but if she was pretending to have asthma she might hand me a card that reads "wheezes at the bases bilaterally".  So, I breezed through my entire exam, skeptically content that some of the vitals must have been incorrect since everything had check out normal to my listening ears and prying fingers.  Normalcy thus inaccurately ascertained, I mapped out a bunch of things, walked her through my differential, and gave her referrals and follow up plans.  In all actuality it turned out pretty okay!  Well, I did for some reason momentarily forget that exam tables are able to rise higher off the ground than an inch, so instead of raising the table to an appropriate height, I just squatted awkwardly on the ground and let her legs precariously dangle drag on the floor during my cardiac examination....but that's small potatoes, right?  I don't recollect a check box for table height on the rubric, so phew.

End result = LAST OSCE DONE.  And that's enough for one day I think.  Check.  Check. Check.

Plus I got to have lunch with this handsome gent. I am winning today.

hello osce my old friend

So, rotation 6 is closed and in the books!  Feeling good!  Julia texted me yesterday and said "at 2:00, we will be exactly 100 days from graduation".  Massive mixed emotions about that one, but if I look closely enough, I thiiink the predominate one is excitement!

But of course, it's not quite a slide to finish just yet.  I am done with my shifts in the ER, but rotation 7 doesn't start until the 17th.  Next week we are all back on campus for lectures and exams and capstone presentations on our final papers of grad school.  It's going to be a jam packed week, and bright and early Monday morn, at the helm of it all, is my final OSCE.  Shudder.  OSCE's are always a mixed bag for me. And by mixed, I mean 99% anxiety-induced-sweaty-terror and 1% adrenaline.  I don't know what it is, I can go in to see a patient in real life without the faintest clue of their chief complaint, and it barely makes me break a sweat.  However, the thought of my professors watching me and videotaping me and scrutinizing my every word and movement, makes me want to crawl into a tiny hole and go to sleep forever.  No matter how many times I tell myself that I am being ridiculous, and am way over thinking the entire thing, my brain still just seizes up and refuses to work properly.  Case in point, at my last one I literally cried in front of the patient, and then my professor, and then the patient again.  Not my finest moment, certainly not my favorite moment to relive via mandatory video watching with reflective paper writing, and even not my favorite moment to admit to.  Yiikes.  Pull it together PA Walsh!

So, LUCKILY that won't happen this time, right?  If I have to sit in contemplative awkward silence for ten minutes with everyone staring at me while I gather my thoughts, so help me god, the words that eventually burst forth from my mouth will be coherent, intelligent, and applicable.  These are the goals, people.  In actuality, I'd consider it a personal win if I manage to make it through the entire encounter with no tears, plus or minus the correct diagnosis.  Sometimes you just GOTTA AIM HIGH. 

So that's my upcoming week in a nutshell.  Fortunately, the fear of Monday is making me forget about my written exams, so instead of worrying about those, I am just sitting in different places around my apartment, wringing my hands. 

And eating cupcakes.

catapult!

Well, folks, I have officially launched myself into the murky sea of the career seeking world.  HIIIYAAAAHHH?  Lordy, it took me a good amount of time to locate and dust off my old resume, at which point I threw it away and started from scratch.  I am pretty sure that no hospital cares that I used to work as a server in downtown Minneapolis and that I perfected my ability to 86' people who were too drunk to order coherently and/or hold their body in an upright and standing position.  I know, it's pretty impressive, but I am moving on to a new crowd.

Resume and clinical summary were slowly, painstakingly completed, and compared to various classmates versions, and reviewed by my school's career specialist, and re-completed....and eventually I AM READY.  The interwebs tell me that the best day and time to apply for a job is mid morning on Mondays.  Ta-da!  So guess what I've been up to today?! 

Mmmhmm.  I have papered southern Maine with all of my carefully-massaged-into-professional-wordings-word-documents, and I'm going broad.  Urgent care, emergency medicine, inpatient cardiology, walk-in clinic, outpatient pediatrics and even one position at a correctional facility.  Look how good I am showcasing my flexible, go-get-em, team player, upbeat shiny, happy and totally employable attitude!

And also, I am knitting, and pretending that because I've applied to places, that I no longer need to beat myself down with incessant studying. 

Oh who am I kidding.  We all know I've got three other tabs open in my browser to various studying materials.  Luckily I have granted myself the luxury of knitting whilst watching lecture videos.  Best of both worlds?